摘要:

This light and electron microscopic study demonstrates an elastic fiber network (EFN) for the levator palpebrae superioris muscle complex, which forms an intricate insertion into the upper eyelid. The EFN is examined in the monkey, in a fresh exenteration specimen, and in fresh frozen cadaver specimens from both sexes of different age groups. Multiple elastic insertions of the levator aponeurosis and Muller's muscle attachment with well-organized elastic fibers are demonstrated using special staining techniques and serial microscopic sectioning. Transmission electron microscopy (TEM) confirms the ultrastructure of “mature” elastin fibers in Muller's muscle tendon and their close relationship with the elastin-related fiber, oxytalan. Current thinking concerning the nature of elastic fibers and their possible implications in acquired involutional blepharoptosis is discussed. This microscopic study of the EFN of the upper eyelid focuses attention on the multiple elastic fiber insertions of the levator muscle complex that includes the levator aponeurosis, the conjoined fascia, the lid crease area, and Muller's muscle tendon, which have not been previously described.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Sixteen asymptomatic volunteers had their right lower puncta occluded with a Freeman silicone plug. They then went about their normal daily activities for approximately 1 week under the stress of a cold Chicago winter. Of the 16 eyes that were plugged, 4 had epiphora. The episodes were of short duration and did not have any effect on the subjects' daily activities. When comparing the incidence of epiphora between the plugged eyes and the control eyes, there was no statistically significant difference (p= 0.082). Also, when comparing the modified Jones / test and Schirmer tests, with and without anesthesia, there was no significant difference in the values between the plugged and the control eyes (p> 0.05). The only difference noted was in the dye disappearance test (p< 0.05). These results support the hypothesis that in selected patients, even under stressful environmental conditions, a single healthy canaliculus may provide sufficient tear drainage from a normal eye to prevent bothersome subjective symptoms

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Congenital nasolacrimal duct (NLD) obstruction, the most common cause of congenital epiphora, occurs in −5% of newborns. Before the advent of canaliculodacryo intubation, management of most cases of partial lacrimal obstruction that failed conservative management and probing necessitated bypass surgery such as dacryocystorhinostomy. Noninvasive closed system lacrimal intubation improved the success rate and provided a non-surgical therapeutic alternative. We present 129 eyes with congenital NLD obstruction managed with silastic lacrimal intubations. Early management is recommended with a minimum of 7 months' retention of the stents. Statistical assessment of results and management of complications is presented.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Acute dacryocystitis frequently is extremely painful and slow to resolve even with systemic antibiotic therapy. We have identified that incision, drainage, and direct application of antibiotics inside the infected sac result in almost immediate resolution of pain and rapid control of infection. This also provides optimal culture material. Twelve consecutive patients treated in this manner had rapid control of the acute infectious process. All eight patients subsequently undergoing dacryocystorhinostomy were fully cured. A total of 58.3% of the patients were infected with gram-negative rods; 50% of the isolates were resistant to most oral antibiotics.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Chronic dacryocystitis is commonly seen in patients requiring a dacryocystorhinostomy (DCR). The infection may be primary, or may be secondary to an anatomical abnormality that has led to tear flow stasis. It is possible that many cases of primary acquired nasolacrimal duct obstruction are in fact secondary to unrecognized low-grade dacryocystitis. The intent of this study was to determine what organisms grow in the lacrimal sac of patients requiring DCR. It also investigated whether or not there was a correlation between organisms cultured from the sac and from the conjunctiva and/or the nose. The results of the study indicate that there is not a clinically significant correlation. The level of obstruction does not affect whether similar organisms were cultured from the three sites.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Adenoid cystic carcinoma of the lacrimal gland is a highly malignant tumor usually characterized by symptoms of less than 1 year's duration. Computed tomographic (CT) findings of adjacent bony erosion or focal tumor sclerosis are also suggestive. We present a 57-year-old female patient who manifested symptoms of an enlarging mass in the right lacrimal fossa for almost 3 years prior to the establishment of the diagnosis of adenoid cystic carcinoma. CT findings during those years were not supportive for malignancy. The treatment included en bloc resection of the mass and adjacent bone and radiotherapy.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This report describes the unusual occurrence of acute dacryocystitis secondary to exudative rhinitis. An 18-year-old man with no prior history of tearing or dacryocystitis presented with acute left dacryocystitis. Nasal mucosal edema, lymphoid hyperplasia, and exudate obstructed the ostium of his left nasolacrimal duct. The patient improved rapidly with systemic antibiotic and nasal decongestant drugs. Both the nasolacrimal duct obstruction and dacryocystitis resolved completely within 2 weeks. One year later, serology suggested Epstein-Barr virus as the cause of the rhinitis. Acute intra-nasal inflammation may obstruct the nasolacrimal duct with potential secondary dacryocystitis. This type of nasolacrimal duct obstruction resolves without sequelae when the rhinitis improves.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Sinus surgery has multiple potential ocular complications including visual loss, diplopia, infection, hemorrhage, and epiphora. We report six patients with ocular motility problems secondary to sinus surgery, review the literature on ocular motility disorders secondary to sinus surgery, and propose an approach for management of those ocular motility problems following sinus surgery. Intranasal sinus surgery was found to be the most common procedure resulting in injury to an extraocular muscle and the ethmoid sinus the most common structure being operated on when injury occurred. The medial rectus was the muscle most commonly injured and it had the poorest prognosis for recovery of functional vision free of diplopia. Optimal timing for repair depends on the structure injured, but early recognition and management appear to be a key to the best outcome for these injuries.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We report the occurrence, surgical treatment and long-term follow-up of a spontaneous, direct carotid-cavernous fistula in a child. It is the third angiographically documented, spontaneously occurring fistula to be reported in this age group and the first to arise directly from the internal carotid artery based on our review of the literature. Although our patient required fistula closure, other reported fistulae were nonprogressive and did not require treatment. The communication between the internal carotid artery and the cavernous sinus was left sided while the contralateral eye was proptotic. The clinical features, selected hemodynamic characteristics, and treatment of carotid-cavernous fistulas are reviewed.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID